Key update for anyone on Atorvastatin for cholesterol after 'safer choice' alert

Key update for anyone on Atorvastatin for cholesterol after 'safer choice' alert Research showed in some circumstances different cholesterol-lowering drugs reduce risk A key update has been given for anyone on statin drugs like Atorvastatin, Simvastatin and Rosuvastatin. For patients at increased risk of haemorrhagic stroke, a class of cholesterol-lowering drugs known as PCSK9 inhibitors may be a safer choice for cholesterol management than statins, according to a new study by UCLA researchers. An estimated 7 to 8 million adults take statins across the UK to help lower their cholesterol and reduce the risk of heart attacks and strokes. They are powerful cholesterol-lowering medications that also reduce the risk of heart disease. Statins also reduce the risk of the most common type of stroke – ischaemic stroke due to plaque buildup in blood vessels. But some studies have suggested they may increase the risk of less-common haemorrhagic strokes – bleeding in the brain due to blood vessel rupture. The research was cited in a number of new publications this month after originally released in Stroke. Jeffrey Saver, professor of neurology and director of the Comprehensive Stroke and Vascular Neurology Program at the David Geffen School of Medicine at UCLA said: “In the past, we were limited in what we could do about the possible increased risk of haemorrhagic stroke, because we didn’t have great alternative agents to statins.” In the last few years, however, a new class of drugs called PCSK9 inhibitors have come on the market. “They lower cholesterol as strongly or even more than the statins do, and they appear to have fewer off-target effects,” The UCLA used data from 36 completed randomised trials to evaluate even rare side effects. One such side effect appears to be an increase in the risk of haemorrhagic strokes. Statins block an enzyme in the liver called HMG-CoA reductase, which the liver needs to make cholesterol. By stopping this enzyme, statins cut off cholesterol production at the source. Because the liver makes less cholesterol, it senses a shortage and pulls more “bad” low-density lipoprotein (LDL) cholesterol out of your bloodstream to use instead Statins help draw cholesterol out of existing fatty plaques inside artery walls, making those plaques more stable and less likely to rupture or trigger dangerous blood clots. Ensure our latest health headlines always appear at the top of your Google Search by making us a Preferred Source. Click here to activate or add us as Preferred Source in your Google search settings Prof Saver said: “Statins have been a mainstay of cholesterol-lowering therapy for 20 years. They have in general been a tremendous benefit to patients with vascular disease worldwide.” They reduce the chance of blood clotting, which can preventing ischaemic strokes, which occur when clots block the flow of blood in the brain. However, haemorrhagic strokes happen when a blood vessel in or around the brain ruptures and bleeds. This blood pools in or around the brain tissue, increases pressure inside the skull, and deprives brain cells of vital oxygen - so the reduction of clotting through statins doesn’t assist prevention of this. Prof Saver said PCSK9 inhibitors “work through an entirely different mechanism,” says. They found that statins increased the risk of haemorrhagic stroke very slightly in all patients. The risk was higher in patients taking high doses of statins and in patients who had some baseline injury to the brain from a prior ischaemic stroke. And the risk was highest in patients who had already had a prior haemorrhagic stroke. Prof Saver explained: “Patients with a past ischaemic stroke went from a 1.1% chance of haemorrhagic stroke to a 1.6% chance.” For these patients, he says, “the benefit of statins in terms of reducing ischaemic stroke greatly outweighs this slight risk of haemorrhagic stroke.” But in the small subset of patients who had previously suffered a haemorrhagic stroke, taking statins increased their risk of a future brain bleed by about four times.